This invention relates generally to a holder used to secure a body limb, such as a leg, during a medical or surgical procedure. More particularly, the holder is used to first position the limb in a selected position. The position of the limb can be adjustably set along a number of different axes. Once the position of the limb is set, the limb holder holds the limb in that position to facilitate the performance of a procedure on the patient.
When a medical or surgical procedure is performed on a limb, an arm or leg, it is desirable to restrict movement of the limb. Without holding the limb steady, it can become impossible for the practitioner to perform procedures on the limb. Further, with an increasing frequency, surgical procedures are performed with the aid of surgical navigation systems. This type of system often includes one or more trackers and a camera. In one version of this system, at least one tracker 2000, for example as shown in FIGS. 53-54, is attached to the patient. For example, the tracker 2000 is shown adapted to be used with a general instrument 2300. In order to couple the tracker 2000 to the general instrument 2300, an adapter 2302 may be connected to an adapter interface 2210 of the tracker 2000 and the general instrument 2300 is attached by a clamp screw 2304. Based on the signals emitted by the tracker, the camera and associated software determines the position of the tracker. By extension, this leads to the determination of the position of the attached patient. (Some surgical navigation systems have trackers with units that, instead of emitting energy, track energy emitted from the static source.) For many surgical navigation systems to operate, the trackers and camera must be in close proximity to each other. This means that it may be necessary to restrain the movement of the limb so that the tracker and complementary camera are able to engage in the appropriate signal exchange. Surgical navigation systems are described more fully in U.S. Pat. No. 7,725,162, the entire contents of which are hereby incorporated by reference herein.
Presently there are a number of different devices that can be used to hold the limb of the patient. These devices include some sort of shell or frame designed to receive the limb. Structural members hold the shell or frame to the operating table. At the start of the procedure, the patient's limb is placed in the shell. The shell is positioned at a location which allows the practitioner to perform the procedure. If a navigation unit is used to facilitate the procedure, the shell is further positioned to ensure that any components of the system fitted to the patient are within the appropriate range to the complementary static components of the system.
Available limb holders are able to hold the limb of the patient in a fixed position. However, there are limitations associated with some of these limb holders. Sometimes during a procedure, the practitioner may want to move a portion of the patient. For example, during some orthopedic surgical procedures on the knee, the practitioner may want to bend the knee so that the patient's leg is moved between the extended (straight) and flexed (bent) positions. Some available limb holders are designed so that, to move the limb, the actual limb holding component is temporarily disconnected from the other components of the assembly. This means that, to reposition the limb, the limb holder is first disconnected and then moved. Once the limb holder is repositioned it is reattached to the other assembly components. Having to perform all these steps makes repositioning the limb a complicated task.
Still other limb holder assemblies comprise components that only allow the attached limb to be move in between a number of defined positions. This means that the practitioner may not be able to make precise or small adjustments of limb positioned that may be desired in order to accomplish a particular medical or surgical procedure.
Also, prior to placing the patient on a surgical table, it is common practice to place a sterile drape on the table. This drape functions as a sterile barrier between the table and the patient. Some available limb holders are designed to be attached directly to the tables with which the holders are used. At the location where this type of limb holder is attached it is difficult, if not impossible to, place the drape around and/or under the limb holder so as to provide the desired sterile barrier.